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Our findings should serve as an alarm, particularly given that rates of depression in the Arab countries are expected to increase rapidly in the context of the Arab Spring. Healthcare providers, researchers, and educators should focus attention on developing effective and culturally appropriate screening, prevention, and intervention approaches using evidence-based guidelines to promote Jordanian adolescent mental health, particularly for depression.

Popularity of waterpipe smoking or hookah smoking in the United States has been growing for some time now among youth and young adults. Currently, many cities and states have exemptions that allow hookah bars to remain in operation despite the passage of clean indoor air legislation. From a public health perspective this is concerning for many reasons. One public health concern with the increase in popularity of this type of tobacco use is the associated health effects. Another concern is that hookah smoke produces a sweet smelling aroma making it less obvious that patrons and employees of hookah bars are inhaling noxious fumes from mainstream smoke, as well as the toxins from the charcoal that is used to heat the tobacco. The purpose of this paper is to discuss smoke-free air legislation in relation to hookah use, the public health implications of exempting hookah bars from current smoke-free legislation, and implications for the public health nurse in protecting the public from the dangers of second-hand smoke, and limiting this new form of tobacco use.

This web-based, cross-sectional survey guided by the Theory of Reasoned Action (TRA), examined behavioral beliefs and normative beliefs associated with smoking tobacco using a waterpipe in a sample of 223 undergraduate college students. Beliefs and norms associated with waterpipe smoking intention were captured using the investigator-developed TRA Waterpipe Questionnaire. Significant behavioral beliefs that contributed to the prediction of smoking intentions included smoking tobacco with a waterpipe “will taste pleasant” and “will allow me to have a good time with my friends.” Significant norms that emerged were perceived approval of waterpipe smoking from friends and significant others. Current smoking status, both waterpipe and cigarette, also contributed to the prediction of smoking intention. The variables of the TRA represent prime targets for intervention and provide useful information that can be used to tailor waterpipe prevention messages.